PEDIATRICS Vol. 56 No. 4s October 1975, pp. 625-692
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Criteria for Evaluation of Ambulatory Child Health Care by Chart Audit: Development and Testing of a Methodology

Final Report of the Joint Committee on Quality Assurance of Ambulatory Health Care for Children and Youth

Charles E. Osborne M.D. and Hugh C. Thompson M.D.

In May 1970, the Executive Board of the American Academy of Pediatrics (AAP) directed its Committee on Standards to study methods by which the quality of ambulatory health care for children and youth might be evaluated. Recognizing that medical care for children is provided by physicians with varying backgrounds, training, and experience, the focus of the study was to be solely on the quality of care provided. The position of the AAP is that children from all sections of the country should receive the same basic quality of care.

The Joint Committee on Quality Assurance (JCQA) was formed in January 1971. Each major organization whose members provide at least some primary care for children was invited to participate: the AAP; the American Academy of Family Physicians; the American Medical Association; the American Public Health Association; the American Osteopathic Association; the Department of Health, Education, and Welfare; the American Society of Internal Medicine; the Ambulatory Pediatric Association; the Student American Medical Association; and the National Medical Association. The membership included physicians from urban and rural areas throughout the United States and both individual and group private practice as well as from academic institutions.

A major goal of the study was to provide physicians and medical groups with empirically based criteria and a tested methodology for establishing peer review guidelines. The purpose of these guidelines was to assess by chart audit the quality of ambulatory health care provided regardless of the provider, the geographic area, the setting, or the delivery system. One of the Committee's first tasks was to agree on an operational definition of quality of care.